HHS CTO: Technology in healthcare is a Trojan Horse for culture change

By Jonah Comstock
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Susannah Fox, current Chief Technology Officer at HHS and former Pew researcher, knows it's a little odd that, as CTO, her background is in anthropology, not technology. But she thinks it's also illustrative of the role technology has to play in healthcare.

“We’re living through this time right now where technology is a Trojan Horse for change,” Fox said yesterday at HxR in Boston. “We say technology, but we mean innovation. We say interoperability and open data, but we mean culture change. And this is why the HHS CTO is an anthropologist. I know about culture change. I know how difficult it is for everyone involved.”

The thrust of that culture change, Fox said, is the democratization of technology development being enabled by the internet — in the first wave a greater access to data and easier innovation of software, but now, thanks to innovations like crowdfunding and 3D printing, easier innovation of hardware too. 

“I wanted to open the aperture so technology isn’t just code or health IT, it’s also about hardware,” Fox said. “Inventors in this case are anyone who designs or develops creative physical solutions, objects, wearables, or devices, with an eye toward improving the health of themselves and others. To help people live more independently, in better health, and with better dignity.”

Part of this is just making sure innovation can come from all levels of an organization, rather than being constrained by hierarchies. But it’s also enabling innovation to spring from patients.

“User innovation is most often motivated by personal need, it’s often not motivated by profit,” she said. “They hack something together, they innovate and then they give it away. Smart organizations look for those lead users.”

Those patients already exist — Fox pointed to the #WeAreNotWaiting movement in the diabetes space, and patients hacking together age-related disability solutions. It falls on the industry to support those innovators.

“The old world is one where designers ignore lead users, or even block their access, forbidding modification of devices,” she said. “What [economist Eric] Von Hippel calls ‘we innovate, you consume.’ The shift to the user innovation model rewards those manufacturers who see those innovations, are open to people’s suggestions, or even hand them the tools to modify a device. They walk alongside the user and they enlist them as partners.”

HHS is already enabling some healthcare-focused maker spaces like E-nable, which open sources 3D-printable prosthetic designs to help people who are missing limbs or partial limbs have a low-cost option.

“We are at a critical inflection point in our history when we are in a better position than ever before to leverage the American spirit of innovation to create ways for people to live longer, with better health and more dignity,” she said. “This is something we desperately need. We need to innovate our way out of the aging trends we’re facing.”